Common Sense Family Doctor

DECEMBER 14, 2024

James Stevermer and Kenneth Fink wrote in an AFP editorial : Few men diagnosed with and treated for prostate cancer will experience a mortality benefit, and an estimated 20% to 50% of those treated will never become symptomatic, even without treatment. Explaining the AAFP’s position, Drs. Watchful waiting refers to clinical observation only.

Screening 52

Screening Routine Screenings Complication Diagnose 52

The Clinical Problem Solvers

FEBRUARY 9, 2020

Objectives Define likelihood ratios and their utility in diagnostic reasoning Identify how likelihood ratios alter the probability of a diagnosis Apply likelihood ratios in clinical reasoning What are likelihood ratios and how do they work? A LR > 1 increases the probability of a specific diagnosis. Luckily, Dr.

Clinic 52

Clinic Diagnosis Hypertension Patients 52

AMMD

FEBRUARY 14, 2025

The average age of a breast cancer diagnosis has statistically been around 65. Now, roughly 9% of breast cancer diagnoses are in women under age 45 with this percentage continually rising(1). I will have an article about the dangers of gadolinium dye soon. Breast Cancer, as are all cancers, is on the rise. Don’t worry!

Diagnosis 130

Diagnosis Screening IT Patient-Centered 130

The Clinical Problem Solvers

SEPTEMBER 28, 2019

If you’re anything like me, you’ve probably found yourself asking that question after listening to a discussant on the podcast arrive at some unexpected diagnosis, only to have the biopsy or lab test prove them right. “How do they do it?!!” Some specific activities mentioned by the participants included patient-directed reading (e.g.,

Lab Testing 52

Lab Testing Clinic Education Clinical Practice 52

GeriPal

OCTOBER 13, 2022

Sonali Advani and Lona Mody talk about their recent JAGS article highlighting three recent articles that every clinician caring for older adults should be aware of in the treatment of infectious diseases (hint: I’ve never finished a course of antibiotics, and maybe your patients don’t need that full course either). This is Eric Widera.

Complication 97

Complication Patient-Centered IT Patients 97

PEMBlog

OCTOBER 26, 2023

Background Meckel diverticulum is a congenital abnormality of the small intestine and is the most common cause of significant lower gastrointestinal bleeding in children. It arises from incomplete involution of the vitelline duct during embryonic development, typically occurring by the 7th week of gestation. ” An et.

Diagnosis 64

Diagnosis Complication Consulting Management 64

GeriPal

JULY 19, 2024

There’s an article about her in New York Times. Summary Transcript Summary The US Preventive Services Task Force (USPSTF) concluded back in 2000 that there is insufficient evidence to recommend for or against routine screening for dementia in older adults. Should it? If so, how do we screen and who do we screen? Soo 00:32 Thanks.

Screening 119

Screening Primary Care Patient-Centered IT 119

GeriPal

MARCH 14, 2024

We also talk about the importance of a proactive approach to involving speech-language pathologists in the care of individuals early on with neurodegenerative diseases like dementia and ALS. Eric: Alex, we got a great show today on Dysphagia Revisited. Who do we have on with us today? Alex: Revisit thickened liquid challenge is back, baby.

IT 124

IT Patient-Centered Hospital Individual 124

GeriPal

NOVEMBER 9, 2023

On the other hand, there is a concerning side, described in this Guardian article titled, I’m a life coach, you’re a life coach: rise of an unregulated industry. Summary Transcript Summary Coaching is in. When I was a junior faculty, coaching wasn’t a thing. We address: What is coaching? How does it differ from therapy? This is Eric Widera.

Board-Certified 110

Board-Certified IT Primary Care Referral 110

GeriPal

DECEMBER 2, 2022

We discuss the importance of viewing individuals with dementia from a lens of resilience, the importance of creative engagement ( as noted in Anne and Susan’s wonderful article on this subject) , the role of collaborative care, and what we can do to improve inclusivity for individuals with dementia in our community and health care systems.

Community 101

Community IT Individual Patient-Centered 101

GeriPal

MAY 11, 2023

And because we can’t resist, we dip into aducanumab and lecanemab at the end. AlexSmithMD Transcript Eric: Welcome to the GeriPal Podcast. This is Eric Widera. Kristine, do you have a song request for Alex? Kristine: Well, I did have a song, but I was negligent at giving it to him. So, he tried to read my mind… Eric: What was your song?

Physicals 85

Physicals IT Hypertension Education 85

Rao Doctor

APRIL 3, 2025

In my previous article I covered the types of illness and the causes. In case you have missed it, click below to read- FEVER FAQ- Part 1 Fever Diagnosis: How is your health assessed? When assessing a fever, we doctors employ a systematic approach to ensure accurate diagnosis and effective management. FEVER FAQs (contd.)

Diagnosis 130

Diagnosis Management Illness Diagnose 130

GeriPal

FEBRUARY 6, 2025

So, the question becomes, what, if anything, should we do differently in the primary care setting to diagnose the disease? We address the following questions with Nate: Has anything changed for the primary care doctor when diagnosing Alzheimers? How should we screen for cognitive impairment? Does a good history matter anymore?

Primary Care 95

Primary Care Diagnosis Screening IT 95

Myriad Genetics

MARCH 19, 2024

A study by the American Cancer Society and published in CA: A Cancer Journal for Clinicians found that half of all new colorectal cancer diagnoses are in people 66 and younger. Though scientists haven’t determined the specific reasons, an article on the Keck Medicine of USC website indicates poor diet and sedentary behavior could play a role.

Individual 52

Individual Screening Diagnose Family 52

GeriPal

JANUARY 30, 2025

Find out on this weeks podcast where we invite Joseph Greer, Simone Rinaldi, and Vicki Jackson to talk about their recent JAMA article on Telehealth vs In-Person Early Palliative Care for Patients With Advanced Lung Cancer – A Multisite Randomized Clinical Trial. But watch out! Alex 01:06 Yeah, go in person. Vicki 02:10 Thank you.

Telehealth 105

Telehealth Patient-Centered IT Patients 105

GeriPal

OCTOBER 17, 2024

I’d also like to give a shout out to a recent ACP article on HFpEF with an outstanding contribution from Ariela Orkaby, geriatrician extraordinaire (we also just did a podcast with her on frailty ). ** This podcast is not CME eligible. He’s in Boston. And also I was in the HVMA primary care program. Parag 01:06 Thank you.

Primary Care 113

Primary Care Patient-Centered IT Patients 113

GeriPal

JANUARY 18, 2024

Summary Transcript Summary The CDC’s Guideline for Prescribing Opioids for Chronic Pain excludes those undergoing cancer treatment, palliative care, and end-of-life care. After discussing screening options for substance use disorder, we go on to talk about both the treatments for it and the issues that arise. Jessie, welcome back to GeriPal.

Illness 136

Illness Patient-Centered Screening Clinic 136

GeriPal

JUNE 15, 2023

For example, there was one article that we reviewed for Jags where it asked great questions, they gave great prompts, and ChatGPT answered great questions about antipsychotics and gave a list of references to back up ChatGPT’s assertions. I’m sure this is a subject we will return to, given the rapid progress on AI. ” Eric: Oh!

IT 99

IT Patient-Centered Patients Healthcare 99

GeriPal

OCTOBER 20, 2022

This all came out from JAGS just published their first Clin-STAR corner, which is, and we’ll talk about what that is, but it’s a series of articles bringing in specialists to talk about updates in the last couple years within their field. Mody for the mentorship and for the opportunity to bring together these articles.

Patient-Centered 52

Patient-Centered Complication IT Patients 52

GeriPal

APRIL 14, 2022

And if you want to learn more about buprenorphine from these amazing palliative care clinicians and others, check out of some of these articles: Learn more about caring for those with substance use disorder: . Article on buprenorphine in the elderly. It’s been around for a long time but is acting like the hot new kid in town.

Illness 102

Illness Patient-Centered IT Patients 102

GeriPal

JUNE 16, 2022

First, we talk with Christine, a researcher and geriatrician from the University of North Carolina, who recently published a JAGS article titled Overdiagnosis of urinary tract infections by nursing home clinicians versus a clinical guideline. But before we get into this topic, does someone have a song request? Chrissy: I do. Alex: (Singing).

Management 122

Management IT Medical Patient-Centered 122

GeriPal

SEPTEMBER 1, 2022

So in preparation for this, I read a couple articles about social work leadership in palliative care. And the title of his article is, does culture of modern day palliative care social work leave room for leadership, where he interviewed six leaders in palliative care, five or six for social workers. by: Anne Kelly, LCSW, APHSW-C.

IT 102

IT Families Family Clinic 102

PEMBlog

JUNE 2, 2025

What you can expect to learn from this article: Recognize signs of end-organ injury when BP is 95th percentile + 30 mmHg. Before your blood pressure rises as well, know that this PEMBlog article is here to provide an overview of the recognition and management of hypertensive emergencies.

Hypertension 75

Hypertension Management Physicals Lab Testing 75

GeriPal

JULY 28, 2022

And I just want to highlight, Jennifer has a great JPSM article that just came out. Would you also just mind mentioning kind of the JPSM article too? What drove you to write that article on this important trip to Seattle? But before we do, I think somebody has a song request for Alex. Alex: (singing). Areej: Wow. Jennifer: Yeah.

Illness 110

Illness Hospital Patient-Centered Patients 110

GeriPal

FEBRUARY 22, 2024

Unfortunately, we lack the financial structures to reimburse psychologists that would incentivize widespread inclusion on palliative care teams. Because we live in the world as it is, not as it should be, Des has helped develop an app ( link to pilot trial hot off the press !) ABIM MOC credit will be offered to subscribers in November, 2024.

Mental Health 122

Mental Health Patient-Centered Illness Screening 122

GeriPal

AUGUST 31, 2023

You’re a senior author on this article in JPSM, where you interviewed some geriatricians and other people caring for older adults, nurse practitioners, social workers, et cetera. We could have talked for hours! And I get to play a Bob Dylan song that’s been on my bucket list to learn. We have a Canadian theme going. Was it April 1st?”

Illness 128

Illness IT Diagnose Medical 128

GeriPal

AUGUST 17, 2023

There is a lot to digest with these draft clinical guidelines but the big change from the 2018 guideline is moving Alzheimers to a biological diagnosis (biomarker evidence only) not just for a research framework but now from a clinical one. Eric: Yeah, he is the host of my favorite dementia podcast. Dementia Matters. Dementia Matters.

Patient-Centered 98

Patient-Centered IT Clinic Patients 98

GeriPal

FEBRUARY 23, 2023

Today we talk with Anne Rohlfing, Lynn Flint, and Anne Kelly, authors of a JGIM article on the reasons we shouldn’t stop at “no.” We owe it to the patient to explore the reasons behind the “no,” commonly not wanting to be a burden to their family. That’s a huge amount of news all at once. This is Eric Widera. Alex: This is Alex Smith.

Family 97

Family Families Patient-Centered IT 97

GeriPal

AUGUST 25, 2022

Second, Hospice was originally designed for patients with advanced cancer, but the fastest growing admitting diagnosis is dementia. It’s something we need to pay attention to, which is what we were talking about in the article. People with dementia make up about half of hospice admissions. Is it you, Melissa? Yes, it is.

Family 106

Family Families IT Patients 106

GeriPal

MARCH 7, 2024

Check out the Pub Crawl GeriPal post for more info, and follow #HPMParty on Twitter to keep us as we crawl! ** In the last several years, I’ve seen more and more articles about end-of-life doulas ( like this NY Times article from 2021 ). I’m unsure what they do, how often they’re used, and who pays for their work. John: I do.

Provider 117

Provider Illness IT Healthcare 117

GeriPal

FEBRUARY 27, 2025

Do you need to be an addiction medicine trained physician to start such a clinic (no: Sach is not). See Sachs write up about setting up this clinic in JPSM. What is harm reduction and how can we implement it in practice? Who follows the patient once the cancer goes into remission? Who will prescribe the buprenorphine then? Oh, my goodness.

Patients 72

Patients Clinic Patient-Centered Illness 72

GeriPal

JANUARY 11, 2024

Summary Transcript Summary Four percent of deaths in Canada are due to Medical Assistance in Dying (MAID). Four percent. The number of people who have used MAID in Canada since it was legalized in 2016 has increased year on year from about 1,000 people in the first year to over 13,000 people in 2022. It is the slippery slope made real. Oh my gosh.

Illness 144

Illness IT Medical Provider 144

GeriPal

OCTOBER 27, 2022

Eric: 1982. James: … alive in the 1980s, but yes, you sang Forever Young by Bob Dylan around three years ago, and then Eric jokingly started singing this song, and so now it’s about time to fulfill Eric’s request. Alex Smith: Sei, do you have any comment? It was kind of the junior high party. Alex Smith: (Singing). Eric: Yeah.

IT 95

IT Clinic Screening Patients 95

AMMD

APRIL 1, 2025

Before I do, I want to set the intention for this article. Technically, no… but it’s a little more complicated than that. I’ll explain more about what I mean in a moment. We’re going to discuss what candida is and how it spreads. I’ll also share ways you can fix and prevent candida overgrowth from a functional medicine perspective.

Diagnose 130

Diagnose IT Provider Healthcare 130

GeriPal

APRIL 18, 2024

We discuss, among other things: Findings that in several studies AI was rated by patients as more empathetic than human clinicians (not less, that isn’t a typo). Turns my concern about lack of empathy from AI on its head – the AI may be more empathetic than clinicians, not less. ” Eric: What was it called again, Wachter’s World?

IT 139

IT Electronics Patients Healthcare 139

GeriPal

SEPTEMBER 19, 2024

Summary Transcript CME Summary If palliative care was a drug, one question we would want to know before prescribing it is what dose we should give. Give too little – it may not work. But before we jump into that topic, Jennifer, do you have a song request for Alex? Jennifer 01:20 I do have a song request for Alex. Saw them play a couple times.

Patient-Centered 119

Patient-Centered IT Patients Hospital 119

GeriPal

JUNE 26, 2025

Tsai-Chin’s article, published in Lancet Healthy Longevity, found a tantalizing hint that countries with stronger safety nets had lower incidence of wealth shocks, and less of a deleterious impact of the wealth shock on cognitive function. This is Eric Widera. Alex 00:12 This is Alex Smith. Eric 00:13 And Alex, who do we have with us today?

Illness 93

Illness Hospital IT Patient-Centered 93